One of the few things we will not manage remotely. It needs a chest listened to — and often an X-ray.
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Pneumonia is an infection of the lung tissue itself. The tiny air sacs fill with fluid and pus, so less oxygen crosses into the blood. It is not the same thing as bronchitis, which affects the airways rather than the lung tissue, and the difference matters because it changes how ill you become.
We will be direct about our limits here. This is one of the few conditions on this site that we will not manage remotely. Diagnosing pneumonia properly means listening to a chest, counting a breathing rate, measuring oxygen levels and often taking a chest X-ray. None of that is possible over video, and getting it wrong is dangerous.
The most important thing on this page concerns older people. Pneumonia in someone over about 75 frequently arrives without fever and without much of a cough. It shows up as new confusion, a fall, drowsiness, going off food, or simply being "not themselves". That presentation is missed constantly, and it is missed because everyone — including doctors — is waiting for a cough and a temperature that never come.
Most people who are otherwise well recover fully. Recovery is slower than most expect, and we have set out the realistic timeline below.
The classic picture is often entirely absent. Instead:
An older person who is suddenly confused needs assessing today. Infection is one of the commonest causes, and pneumonia is one of the commonest infections.
Fast breathing, grunting, drawing in of the ribs or the skin under the ribs, nasal flaring, and poor feeding. Count the breathing rate when they are settled — it is more informative than anything else you can observe at home.
Secondary bacterial pneumonia after influenza is a recognised and dangerous pattern. Getting better from flu and then deteriorating again several days later is the sequence to act on.
CRB-65 is the tool used in the community: one point each for new Confusion, a Respiratory rate of 30 or more, low Blood pressure, and age 65 or over.
Zero suggests home treatment is reasonable; one or two means hospital assessment should be considered; three or four means urgent admission. Every component requires someone physically present.
Guidance is that a repeat chest X-ray at around six weeks should be arranged for anyone with persisting symptoms, and for those at higher risk of lung cancer — in practice, smokers and people over 50.
The reason is straightforward: a tumour can obstruct an airway and cause a pneumonia that treats well and then comes back. A normal X-ray at six weeks closes that question. This step is missed frequently, particularly when someone was treated at home rather than admitted — and it is worth asking about directly.
Acute bronchitis, a flare of COPD or asthma, a clot on the lung, heart failure, lung cancer, tuberculosis, or COVID-19.
We will not diagnose or treat suspected pneumonia remotely. It requires a chest to be listened to, a breathing rate counted, oxygen saturation measured, and frequently a chest X-ray. Prescribing antibiotics for a chest we cannot examine risks both under-treating someone who needs hospital and over-treating someone who has a virus.
If a consultation suggests pneumonia, we will tell you so directly and send you for face-to-face assessment the same day — NHS urgent care, your own practice, or A&E depending on how unwell you are. We would rather do that than take a fee for something we cannot do safely.
Go back if you are no better after 48 to 72 hours of antibiotics, or if you get worse at any point. Antibiotic choice sometimes needs changing, and deterioration on treatment means hospital assessment.
Smoking damages the lungs' clearance mechanisms and is the largest modifiable risk factor. Risk falls steadily after stopping, and NHS stop smoking services are free and considerably more effective than willpower alone.
Recovery takes far longer than most people expect, and knowing the shape of it prevents a great deal of unnecessary worry:
Rest properly, drink plenty, and do not rush back to full activity. Returning to work too early is the commonest reason recovery drags on. Gentle activity that builds week by week is better than resting completely.
We do not want to sell you a consultation for pneumonia. If you have it, you need someone with a stethoscope in the room.
This page follows NICE guideline NG138 on pneumonia in adults, NICE Clinical Knowledge Summaries, and British Thoracic Society guidance on community-acquired pneumonia.
Guidance recognises that older adults may present without fever or classical respiratory symptoms, and that new confusion, functional decline or falls may be the only features. A low threshold for assessment is advised in this group.
Reviewed against NICE NG138, NICE CKS and British Thoracic Society guidance current at the date shown above.
Because pneumonia is diagnosed by listening to a chest, counting a breathing rate and measuring oxygen levels, and often by X-ray. None of that can be done over video.
Guessing risks two bad outcomes: missing someone who needs hospital, or giving antibiotics to someone with a virus. We will point you to same-day face-to-face assessment instead.
Yes, and this is the single most important point on the page. Older people frequently develop pneumonia without fever or cough, presenting instead as confusion, a fall, drowsiness or not eating.
New confusion in an older person needs assessment today, whatever the temperature reads.
Bronchitis affects the airways; pneumonia affects the lung tissue itself. Bronchitis is usually viral, makes you feel rough but rarely dangerous, and does not need antibiotics.
Pneumonia makes you considerably more ill, and the difference is best judged by examination, not by symptoms alone.
Longer than you expect. Fever settles within a week, cough and breathlessness improve markedly by six weeks, and most symptoms are gone by three months.
Full return to normal often takes six months, and lingering tiredness is entirely expected rather than a sign something is wrong.
A repeat chest X-ray to confirm the pneumonia has fully cleared, recommended for people with persisting symptoms and for those at higher risk of lung cancer — smokers and people over 50.
A blockage in an airway can cause a pneumonia that treats and then returns, so this check matters. It is frequently forgotten, and worth asking about.
For genuine bacterial pneumonia, yes. For a chest infection that is actually viral bronchitis, no — and that is precisely what an examination distinguishes.
Amoxicillin is the usual first choice for mild community-acquired pneumonia in the UK.
Usually not. Cough and fatigue commonly persist for weeks after the infection itself has cleared.
Go back if you are getting worse rather than slowly better, if the fever returns, or if breathlessness is increasing.
The organisms spread person to person, but most people who encounter them do not develop pneumonia.
Whether it takes hold depends far more on your lungs, age and immune system than on exposure.
The pneumococcal vaccine if you are 65 or over, or younger with a qualifying long-term condition — usually a single dose.
Plus the annual flu vaccine and COVID vaccination as advised. All are free on the NHS for those eligible.
It is the largest modifiable risk factor, because it damages the lungs' ability to clear infection.
Risk falls after stopping, and free NHS stop smoking services are more effective than going it alone.
August 30, 2026
Ongoing
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£40 for 20 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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